In Reply.—Dr Murray, in discussing the publication of case reports of unusual genetic diseases, brings up the point that such cases are often unique and that maintaining the anonymity of patients may be impossible. He provides some excellent guidelines for dealing with these situations in such a way that publication of the case record is of value both to the patient involved and to the medical community in general.I would suggest that similar guidelines be applied to the publication of all case reports, even when the patient's identity can be adequately concealed. In particular, this would include the suggestions to obtain consent from the patient before submission for publication and providing the patient with a reprint of the article.These measures would serve to enhance doctor-patient communication, since, currently, most patients do not think that cases are published in medical journals. The opportunity for patients to learn about